Provider Demographics
NPI:1477897585
Name:DIGNITY, LLC
Entity Type:Organization
Organization Name:DIGNITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FORSYTH
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA, CRCR
Authorized Official - Phone:478-293-9714
Mailing Address - Street 1:PO BOX 27211
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31221-7211
Mailing Address - Country:US
Mailing Address - Phone:478-250-9828
Mailing Address - Fax:
Practice Address - Street 1:189 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2929
Practice Address - Country:US
Practice Address - Phone:478-250-9828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011-R-1089253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
011-R-1089OtherSTATE OF GEORGIA OFFICE GEORGIA DEPARTMENT OF COMMUNITY HEALTH